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Evaluation and Treatment of the Patient Who Is Regaining Weight

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Foregut Surgery

Abstract

Obesity is a growing worldwide epidemic and an emerging healthcare problem affecting millions of people in the United States. Currently, mortality is less than 1%, and morbidity is under 10%. One significant long-term concern is weight regain. In order to manage weight regain, a multifactorial approach is critical. Options for treatment include behavioral modifications, pharmacological intervention, endoscopic revision, and surgical operations offer additional weight loss and amelioration of comorbidities.

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References

  1. Hales CM, Fryar CD, Carroll MD, Freedman DS, Ogden CL. Trends in obesity and severe obesity prevalence in US youth and adults by sex and age, 2007–2008 to 2015–2016. JAMA. 2018;319(16):1723–5.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Upadhyay J, Farr O, Perakakis N, Ghaly W, Mantzoros C. Obesity as a disease. Med Clin North Am. 2018;102(1):13–33.

    Article  PubMed  Google Scholar 

  3. Dee A, Kearns K, O'Neill C, Sharp L, Staines A, O'Dwyer V, et al. The direct and indirect costs of both overweight and obesity: a systematic review. BMC Res Notes. 2014;7:242.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Lanas F, Bazzano L, Rubinstein A, Calandrelli M, Chen CS, Elorriaga N, et al. Prevalence, distributions and determinants of obesity and central obesity in the southern cone of America. PLoS One. 2016;11(10):e0163727.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  5. Courcoulas AP, Yanovski SZ, Bonds D, Eggerman TL, Horlick M, Staten MA, et al. Long-term outcomes of bariatric surgery: a National Institutes of Health symposium. JAMA Surg. 2014;149(12):1323–9.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J, et al. IFSO Worldwide Survey 2016: primary, endoluminal, and revisional procedures. Obes Surg. 2018;28(12):3783–94.

    Article  PubMed  Google Scholar 

  7. Longitudinal Assessment of Bariatric Surgery C, Flum DR, Belle SH, King WC, Wahed AS, Berk P, et al. Perioperative safety in the longitudinal assessment of bariatric surgery. N Engl J Med. 2009;361(5):445–54.

    Article  Google Scholar 

  8. Stenberg E, Szabo E, Agren G, Naslund E, Boman L, Bylund A, et al. Early complications after laparoscopic gastric bypass surgery: results from the Scandinavian obesity surgery registry. Ann Surg. 2014;260(6):1040–7.

    Article  PubMed  Google Scholar 

  9. Helmio M, Victorzon M, Ovaska J, Leivonen M, Juuti A, Jaser N, et al. SLEEVEPASS: a randomized prospective multicenter study comparing laparoscopic sleeve gastrectomy and gastric bypass in the treatment of morbid obesity: preliminary results. Surg Endosc. 2012;26(9):2521–6.

    Article  PubMed  Google Scholar 

  10. Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.

    Article  PubMed  Google Scholar 

  11. Brethauer SA, Aminian A, Romero-Talamas H, Batayyah E, Mackey J, Kennedy L, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg. 2013;258(4):628–36; discussion 36–7

    Article  PubMed  Google Scholar 

  12. Park JY, Song D, Kim YJ. Causes and outcomes of revisional bariatric surgery: initial experience at a single center. Ann Surg Treat Res. 2014;86(6):295–301.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Braghetto I, Csendes A, Lanzarini E, Papapietro K, Carcamo C, Molina JC. Is laparoscopic sleeve gastrectomy an acceptable primary bariatric procedure in obese patients? Early and 5-year postoperative results. Surg Laparosc Endosc Percutan Tech. 2012;22(6):479–86.

    Article  PubMed  Google Scholar 

  14. Shantavasinkul PC, Omotosho P, Corsino L, Portenier D, Torquati A. Predictors of weight regain in patients who underwent Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis. 2016;12(9):1640–5.

    Article  PubMed  Google Scholar 

  15. Sudan R, Nguyen NT, Hutter MM, Brethauer SA, Ponce J, Morton JM. Morbidity, mortality, and weight loss outcomes after reoperative bariatric surgery in the USA. J Gastrointest Surg. 2015;19(1):171–8; discussion 8–9

    Article  PubMed  Google Scholar 

  16. Brethauer SA, Kim J, el Chaar M, Papasavas P, Eisenberg D, Rogers A, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Surg Obes Relat Dis. 2015;11(3):489–506.

    Article  PubMed  Google Scholar 

  17. Nuttall FQ. Body mass index: obesity, BMI, and health: a critical review. Nutr Today. 2015;50(3):117–28.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Brolin RE, Kenler HA, Gorman RC, Cody RP. The dilemma of outcome assessment after operations for morbid obesity. Surgery. 1989;105(3):337–46.

    CAS  PubMed  Google Scholar 

  19. Reinhold RB. Critical analysis of long term weight loss following gastric bypass. Surg Gynecol Obstet. 1982;155(3):385–94.

    CAS  PubMed  Google Scholar 

  20. Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lauti M, Kularatna M, Hill AG, MacCormick AD. Weight regain following sleeve Gastrectomy-a systematic review. Obes Surg. 2016;26(6):1326–34.

    Article  PubMed  Google Scholar 

  22. Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg. 2010;252(2):319–24.

    Article  PubMed  Google Scholar 

  23. Castagneto Gissey L, Casella Mariolo JR, Genco A, Troisi A, Basso N, Casella G. 10-year follow-up after laparoscopic sleeve gastrectomy: outcomes in a monocentric series. Surg Obes Relat Dis. 2018;14(10):1480–7.

    Article  PubMed  Google Scholar 

  24. Lauti M, Lemanu D, Zeng ISL, Su’a B, Hill AG, MacCormick AD. Definition determines weight regain outcomes after sleeve gastrectomy. Surg Obes Relat Dis. 2017;13(7):1123–9.

    Article  PubMed  Google Scholar 

  25. Sjostrom L. Review of the key results from the Swedish obese subjects (SOS) trial – a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219–34.

    Article  CAS  PubMed  Google Scholar 

  26. Cooper TC, Simmons EB, Webb K, Burns JL, Kushner RF. Trends in weight regain following Roux-en-Y gastric bypass (RYGB) bariatric surgery. Obes Surg. 2015;25(8):1474–81.

    Article  PubMed  Google Scholar 

  27. Kothari SN, Borgert AJ, Kallies KJ, Baker MT, Grover BT. Long-term (>10-year) outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2017;13(6):972–8.

    Article  PubMed  Google Scholar 

  28. Al-Khyatt W, Ryall R, Leeder P, Ahmed J, Awad S. Predictors of inadequate weight loss after laparoscopic gastric bypass for morbid obesity. Obes Surg. 2017;27(6):1446–52.

    Article  PubMed  Google Scholar 

  29. Monaco-Ferreira DV, Leandro-Merhi VA. Weight regain 10 years after Roux-en-Y gastric bypass. Obes Surg. 2017;27(5):1137–44.

    Article  PubMed  Google Scholar 

  30. Keith CJ Jr, Gullick AA, Feng K, Richman J, Stahl R, Grams J. Predictive factors of weight regain following laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2018;32(5):2232–8.

    Article  PubMed  Google Scholar 

  31. Sarwer DB, Wadden TA, Moore RH, Baker AW, Gibbons LM, Raper SE, et al. Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surg Obes Relat Dis. 2008;4(5):640–6.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Kofman MD, Lent MR, Swencionis C. Maladaptive eating patterns, quality of life, and weight outcomes following gastric bypass: results of an internet survey. Obesity (Silver Spring). 2010;18(10):1938–43.

    Article  Google Scholar 

  33. Sudan R, Sudan R, Lyden E, Thompson JS. Food cravings and food consumption after Roux-en-Y gastric bypass versus cholecystectomy. Surg Obes Relat Dis. 2017;13(2):220–6.

    Article  PubMed  Google Scholar 

  34. Rutledge T, Groesz LM, Savu M. Psychiatric factors and weight loss patterns following gastric bypass surgery in a veteran population. Obes Surg. 2011;21(1):29–35.

    Article  PubMed  Google Scholar 

  35. Maleckas A, Gudaityte R, Petereit R, Venclauskas L, Velickiene D. Weight regain after gastric bypass: etiology and treatment options. Gland Surg. 2016;5(6):617–24.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Santo MA, Riccioppo D, Pajecki D, Kawamoto F, de Cleva R, Antonangelo L, et al. Weight regain after gastric bypass: influence of gut hormones. Obes Surg. 2016;26(5):919–25.

    Article  PubMed  Google Scholar 

  37. Tamboli RA, Breitman I, Marks-Shulman PA, Jabbour K, Melvin W, Williams B, et al. Early weight regain after gastric bypass does not affect insulin sensitivity but is associated with elevated ghrelin. Obesity (Silver Spring). 2014;22(7):1617–22.

    Article  CAS  Google Scholar 

  38. Abu Dayyeh BK, Jirapinyo P, Thompson CC. Plasma ghrelin levels and weight regain after Roux-en-Y gastric bypass surgery. Obes Surg. 2017;27(4):1031–6.

    Article  PubMed  Google Scholar 

  39. Knuth ND, Johannsen DL, Tamboli RA, Marks-Shulman PA, Huizenga R, Chen KY, et al. Metabolic adaptation following massive weight loss is related to the degree of energy imbalance and changes in circulating leptin. Obesity (Silver Spring). 2014;22(12):2563–9.

    Google Scholar 

  40. Kim HJ, Madan A, Fenton-Lee D. Does patient compliance with follow-up influence weight loss after gastric bypass surgery? A systematic review and meta-analysis. Obes Surg. 2014;24(4):647–51.

    Article  PubMed  Google Scholar 

  41. Freire RH, Borges MC, Alvarez-Leite JI, Toulson Davisson Correia MI. Food quality, physical activity, and nutritional follow-up as determinant of weight regain after Roux-en-Y gastric bypass. Nutrition. 2012;28(1):53–8.

    Article  PubMed  Google Scholar 

  42. Faria SL, de Oliveira KE, Lins RD, Faria OP. Nutritional management of weight regain after bariatric surgery. Obes Surg. 2010;20(2):135–9.

    Article  PubMed  Google Scholar 

  43. Kinzl JF, Schrattenecker M, Traweger C, Mattesich M, Fiala M, Biebl W. Psychosocial predictors of weight loss after bariatric surgery. Obes Surg. 2006;16(12):1609–14.

    Article  PubMed  Google Scholar 

  44. Marek RJ, Ben-Porath YS, Dulmen M, Ashton K, Heinberg LJ. Using the presurgical psychological evaluation to predict 5-year weight loss outcomes in bariatric surgery patients. Surg Obes Relat Dis. 2017;13(3):514–21.

    Article  PubMed  Google Scholar 

  45. Onofre T, Carlos R, Oliver N, Felismino A, Fialho D, Corte R, et al. Effects of a physical activity program on cardiorespiratory fitness and pulmonary function in obese women after bariatric surgery: a pilot study. Obes Surg. 2017;27(8):2026–33.

    Article  PubMed  Google Scholar 

  46. Coen PM, Tanner CJ, Helbling NL, Dubis GS, Hames KC, Xie H, et al. Clinical trial demonstrates exercise following bariatric surgery improves insulin sensitivity. J Clin Invest. 2015;125(1):248–57.

    Article  PubMed  Google Scholar 

  47. Coen PM, Goodpaster BH. A role for exercise after bariatric surgery? Diabetes Obes Metab. 2016;18(1):16–23.

    Article  PubMed  Google Scholar 

  48. Brethauer SA, Nfonsam V, Sherman V, Udomsawaengsup S, Schauer PR, Chand B. Endoscopy and upper gastrointestinal contrast studies are complementary in evaluation of weight regain after bariatric surgery. Surg Obes Relat Dis. 2006;2(6):643–8.. discussion 9-50

    Article  PubMed  Google Scholar 

  49. Heneghan HM, Yimcharoen P, Brethauer SA, Kroh M, Chand B. Influence of pouch and stoma size on weight loss after gastric bypass. Surg Obes Relat Dis. 2012;8(4):408–15.

    Article  PubMed  Google Scholar 

  50. Abu Dayyeh BK, Lautz DB, Thompson CC. Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass. Clin Gastroenterol Hepatol. 2011;9(3):228–33.

    Article  PubMed  Google Scholar 

  51. Roberts K, Duffy A, Kaufman J, Burrell M, Dziura J, Bell R. Size matters: gastric pouch size correlates with weight loss after laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2007;21(8):1397–402.

    Article  CAS  PubMed  Google Scholar 

  52. Topart P, Becouarn G, Ritz P. Pouch size after gastric bypass does not correlate with weight loss outcome. Obes Surg. 2011;21(9):1350–4.

    Article  PubMed  Google Scholar 

  53. Weiner RA, Weiner S, Pomhoff I, Jacobi C, Makarewicz W, Weigand G. Laparoscopic sleeve gastrectomy--influence of sleeve size and resected gastric volume. Obes Surg. 2007;17(10):1297–305.

    Article  PubMed  Google Scholar 

  54. Parikh M, Gagner M, Heacock L, Strain G, Dakin G, Pomp A. Laparoscopic sleeve gastrectomy: does bougie size affect mean %EWL? Short-term outcomes. Surg Obes Relat Dis. 2008;4(4):528–33.

    Article  PubMed  Google Scholar 

  55. Hawasli A, Jacquish B, Almahmeed T, Vavra J, Roberts N, Meguid A, et al. Early effects of bougie size on sleeve gastrectomy outcome. Am J Surg. 2015;209(3):473–7.

    Article  PubMed  Google Scholar 

  56. Gagner M, Hutchinson C, Rosenthal R. Fifth International Consensus Conference: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2016;12(4):750–6.

    Article  PubMed  Google Scholar 

  57. Abdallah E, El Nakeeb A, Youssef T, Abdallah H, Ellatif MA, Lotfy A, et al. Impact of extent of antral resection on surgical outcomes of sleeve gastrectomy for morbid obesity (a prospective randomized study). Obes Surg. 2014;24(10):1587–94.

    Article  PubMed  Google Scholar 

  58. Obeidat F, Shanti H, Mismar A, Albsoul N, Al-Qudah M. The magnitude of Antral resection in laparoscopic sleeve gastrectomy and its relationship to excess weight loss. Obes Surg. 2015;25(10):1928–32.

    Article  PubMed  Google Scholar 

  59. McGlone ER, Gupta AK, Reddy M, Khan OA. Antral resection versus antral preservation during laparoscopic sleeve gastrectomy for severe obesity: systematic review and meta-analysis. Surg Obes Relat Dis. 2018;14(6):857–64.

    Article  PubMed  Google Scholar 

  60. Mor A, Sharp L, Portenier D, Sudan R, Torquati A. Weight loss at first postoperative visit predicts long-term outcome of Roux-en-Y gastric bypass using Duke weight loss surgery chart. Surg Obes Relat Dis. 2012;8(5):556–60.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Nor Hanipah Z, Nasr EC, Bucak E, Schauer PR, Aminian A, Brethauer SA, et al. Efficacy of adjuvant weight loss medication after bariatric surgery. Surg Obes Relat Dis. 2018;14(1):93–8.

    Article  PubMed  Google Scholar 

  62. Stanford FC, Alfaris N, Gomez G, Ricks ET, Shukla AP, Corey KE, et al. The utility of weight loss medications after bariatric surgery for weight regain or inadequate weight loss: a multi-center study. Surg Obes Relat Dis. 2017;13(3):491–500.

    Article  PubMed  Google Scholar 

  63. Schwartz J, Chaudhry UI, Suzo A, Durkin N, Wehr AM, Foreman KS, et al. Pharmacotherapy in conjunction with a diet and exercise program for the treatment of weight recidivism or weight loss plateau post-bariatric surgery: a retrospective review. Obes Surg. 2016;26(2):452–8.

    Article  PubMed  Google Scholar 

  64. Bessler M, Daud A, DiGiorgi MF, Olivero-Rivera L, Davis D. Adjustable gastric banding as a revisional bariatric procedure after failed gastric bypass. Obes Surg. 2005;15(10):1443–8.

    Article  PubMed  Google Scholar 

  65. Chin PL, Ali M, Francis K, LePort PC. Adjustable gastric band placed around gastric bypass pouch as revision operation for failed gastric bypass. Surg Obes Relat Dis. 2009;5(1):38–42.

    Article  PubMed  Google Scholar 

  66. Irani K, Youn HA, Ren-Fielding CJ, Fielding GA, Kurian M. Midterm results for gastric banding as salvage procedure for patients with weight loss failure after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2011;7(2):219–24.

    Article  PubMed  Google Scholar 

  67. Vijgen GH, Schouten R, Bouvy ND, Greve JW. Salvage banding for failed Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2012;8(6):803–8.

    Article  PubMed  Google Scholar 

  68. Iannelli A, Schneck AS, Hebuterne X, Gugenheim J. Gastric pouch resizing for Roux-en-Y gastric bypass failure in patients with a dilated pouch. Surg Obes Relat Dis. 2013;9(2):260–7.

    Article  PubMed  Google Scholar 

  69. Parikh M, Heacock L, Gagner M. Laparoscopic “gastrojejunal sleeve reduction” as a revision procedure for weight loss failure after roux-en-y gastric bypass. Obes Surg. 2011;21(5):650–4.

    Article  PubMed  Google Scholar 

  70. Al-Bader I, Khoursheed M, Al Sharaf K, Mouzannar DA, Ashraf A, Fingerhut A. Revisional laparoscopic gastric pouch resizing for inadequate weight loss after Roux-en-Y gastric bypass. Obes Surg. 2015;25(7):1103–8.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Jirapinyo P, Kroner PT, Thompson CC. Purse-string transoral outlet reduction (TORe) is effective at inducing weight loss and improvement in metabolic comorbidities after Roux-en-Y gastric bypass. Endoscopy. 2018;50(4):371–7.

    Article  PubMed  Google Scholar 

  72. Schulman AR, Kumar N, Thompson CC. Transoral outlet reduction: a comparison of purse-string with interrupted stitch technique. Gastrointest Endosc. 2018;87(5):1222–8.

    Article  PubMed  Google Scholar 

  73. Horgan S, Jacobsen G, Weiss GD, Oldham JS Jr, Denk PM, Borao F, et al. Incisionless revision of post-Roux-en-Y bypass stomal and pouch dilation: multicenter registry results. Surg Obes Relat Dis. 2010;6(3):290–5.

    Article  PubMed  Google Scholar 

  74. Ryou M, Mullady DK, Lautz DB, Thompson CC. Pilot study evaluating technical feasibility and early outcomes of second-generation endosurgical platform for treatment of weight regain after gastric bypass surgery. Surg Obes Relat Dis. 2009;5(4):450–4.

    Article  PubMed  Google Scholar 

  75. Abu Dayyeh BK, Jirapinyo P, Weitzner Z, Barker C, Flicker MS, Lautz DB, et al. Endoscopic sclerotherapy for the treatment of weight regain after Roux-en-Y gastric bypass: outcomes, complications, and predictors of response in 575 procedures. Gastrointest Endosc. 2012;76(2):275–82.

    Article  PubMed  PubMed Central  Google Scholar 

  76. Ong'uti SK, Ortega G, Onwugbufor MT, Ivey GD, Fullum TM, Tran DD. Effective weight loss management with endoscopic gastric plication using StomaphyX device: is it achievable? Surg Obes Relat Dis. 2013;9(1):113–7.

    Article  PubMed  Google Scholar 

  77. Eid GM, McCloskey CA, Eagleton JK, Lee LB, Courcoulas AP. StomaphyX vs a sham procedure for revisional surgery to reduce regained weight in Roux-en-Y gastric bypass patients: a randomized clinical trial. JAMA Surg. 2014;149(4):372–9.

    Article  PubMed  Google Scholar 

  78. Kellum JM, Chikunguwo SM, Maher JW, Wolfe LG, Sugerman HJ. Long-term results of malabsorptive distal Roux-en-Y gastric bypass in superobese patients. Surg Obes Relat Dis. 2011;7(2):189–93.

    Article  PubMed  Google Scholar 

  79. Rawlins ML, Teel D 2nd, Hedgcorth K, Maguire JP. Revision of Roux-en-Y gastric bypass to distal bypass for failed weight loss. Surg Obes Relat Dis. 2011;7(1):45–9.

    Article  PubMed  Google Scholar 

  80. Srikanth MS, Oh KH, Fox SR. Revision to malabsorptive Roux-en-Y gastric bypass (MRNYGBP) provides long-term (10 years) durable weight loss in patients with failed anatomically intact gastric restrictive operations: long-term effectiveness of a malabsorptive Roux-en-Y gastric bypass in salvaging patients with poor weight loss or complications following gastroplasty and adjustable gastric bands. Obes Surg. 2011;21(7):825–31.

    Article  PubMed  Google Scholar 

  81. Fox SR, Fox KS, Oh KH. The gastric bypass for failed bariatric surgical procedures. Obes Surg. 1996;6(2):145–50.

    Article  CAS  PubMed  Google Scholar 

  82. Sugerman HJ, Kellum JM, DeMaria EJ. Conversion of proximal to distal gastric bypass for failed gastric bypass for superobesity. J Gastrointest Surg. 1997;1(6):517–24; discussion 24–6

    Article  CAS  PubMed  Google Scholar 

  83. Brolin RE, Cody RP. Adding malabsorption for weight loss failure after gastric bypass. Surg Endosc. 2007;21(11):1924–6.

    Article  PubMed  Google Scholar 

  84. Tran DD, Nwokeabia ID, Purnell S, Zafar SN, Ortega G, Hughes K, et al. Revision of Roux-en-Y gastric bypass for weight regain: a systematic review of techniques and outcomes. Obes Surg. 2016;26(7):1627–34.

    Article  PubMed  Google Scholar 

  85. Ghiassi S, Higa K, Chang S, Ma P, Lloyd A, Boone K, et al. Conversion of standard Roux-en-Y gastric bypass to distal bypass for weight loss failure and metabolic syndrome: 3-year follow-up and evolution of technique to reduce nutritional complications. Surg Obes Relat Dis. 2018;14(5):554–61.

    Article  PubMed  Google Scholar 

  86. Keshishian A, Zahriya K, Hartoonian T, Ayagian C. Duodenal switch is a safe operation for patients who have failed other bariatric operations. Obes Surg. 2004;14(9):1187–92.

    Article  PubMed  Google Scholar 

  87. Parikh M, Pomp A, Gagner M. Laparoscopic conversion of failed gastric bypass to duodenal switch: technical considerations and preliminary outcomes. Surg Obes Relat Dis. 2007;3(6):611–8.

    Article  PubMed  Google Scholar 

  88. Gagner M, Rogula T. Laparoscopic reoperative sleeve gastrectomy for poor weight loss after biliopancreatic diversion with duodenal switch. Obes Surg. 2003;13(4):649–54.

    Article  PubMed  Google Scholar 

  89. Baltasar A, Serra C, Perez N, Bou R, Bengochea M. Re-sleeve gastrectomy. Obes Surg. 2006;16(11):1535–8.

    Article  PubMed  Google Scholar 

  90. Iannelli A, Schneck AS, Noel P, Ben Amor I, Krawczykowski D, Gugenheim J. Re-sleeve gastrectomy for failed laparoscopic sleeve gastrectomy: a feasibility study. Obes Surg. 2011;21(7):832–5.

    Article  PubMed  Google Scholar 

  91. Nedelcu M, Noel P, Iannelli A, Gagner M. Revised sleeve gastrectomy (re-sleeve). Surg Obes Relat Dis. 2015;11(6):1282–8.

    Article  PubMed  Google Scholar 

  92. Casillas RA, Um SS, Zelada Getty JL, Sachs S, Kim BB. Revision of primary sleeve gastrectomy to Roux-en-Y gastric bypass: indications and outcomes from a high-volume center. Surg Obes Relat Dis. 2016;12(10):1817–25.

    Article  PubMed  Google Scholar 

  93. Quezada N, Hernandez J, Perez G, Gabrielli M, Raddatz A, Crovari F. Laparoscopic sleeve gastrectomy conversion to Roux-en-Y gastric bypass: experience in 50 patients after 1 to 3 years of follow-up. Surg Obes Relat Dis. 2016;12(8):1611–5.

    Article  PubMed  Google Scholar 

  94. Iannelli A, Debs T, Martini F, Benichou B, Ben Amor I, Gugenheim J. Laparoscopic conversion of sleeve gastrectomy to Roux-en-Y gastric bypass: indications and preliminary results. Surg Obes Relat Dis. 2016;12(8):1533–8.

    Article  PubMed  Google Scholar 

  95. Carmeli I, Golomb I, Sadot E, Kashtan H, Keidar A. Laparoscopic conversion of sleeve gastrectomy to a biliopancreatic diversion with duodenal switch or a Roux-en-Y gastric bypass due to weight loss failure: our algorithm. Surg Obes Relat Dis. 2015;11(1):79–85.

    Article  PubMed  Google Scholar 

  96. Gautier T, Sarcher T, Contival N, Le Roux Y, Alves A. Indications and mid-term results of conversion from sleeve gastrectomy to Roux-en-Y gastric bypass. Obes Surg. 2013;23(2):212–5.

    Article  PubMed  Google Scholar 

  97. Landreneau JP, Strong AT, Rodriguez JH, Aleassa EM, Aminian A, Brethauer S, et al. Conversion of sleeve gastrectomy to Roux-en-Y gastric bypass. Obes Surg. 2018;28(12):3843–50.

    Article  PubMed  Google Scholar 

  98. Homan J, Betzel B, Aarts EO, van Laarhoven KJ, Janssen IM, Berends FJ. Secondary surgery after sleeve gastrectomy: Roux-en-Y gastric bypass or biliopancreatic diversion with duodenal switch. Surg Obes Relat Dis. 2015;11(4):771–7.

    Article  PubMed  Google Scholar 

  99. Weiner RA, Theodoridou S, Weiner S. Failure of laparoscopic sleeve gastrectomy–further procedure? Obes Facts. 2011;4(Suppl 1):42–6.

    PubMed  PubMed Central  Google Scholar 

  100. Sanchez-Pernaute A, Herrera MA, Perez-Aguirre ME, Talavera P, Cabrerizo L, Matia P, et al. Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S). One to three-year follow-up. Obes Surg. 2010;20(12):1720–6.

    Article  PubMed  Google Scholar 

  101. Neichoy BT, Schniederjan B, Cottam DR, Surve AK, Zaveri HM, Cottam A, et al. Stomach intestinal pylorus-sparing surgery for morbid obesity. JSLS. 2018;22(1):e2017.00063.

    Article  PubMed  PubMed Central  Google Scholar 

  102. Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11(3):276–80.

    Article  CAS  PubMed  Google Scholar 

  103. Sanchez-Pernaute A, Rubio MA, Conde M, Arrue E, Perez-Aguirre E, Torres A. Single-anastomosis duodenoileal bypass as a second step after sleeve gastrectomy. Surg Obes Relat Dis. 2015;11(2):351–5.

    Article  PubMed  Google Scholar 

  104. Dijkhorst PJ, Boerboom AB, Janssen IMC, Swank DJ, Wiezer RMJ, Hazebroek EJ, et al. Failed sleeve gastrectomy: single anastomosis duodenoileal bypass or Roux-en-Y gastric bypass? A Multicenter Cohort Study. Obes Surg. 2018;28(12):3834–42.

    Article  PubMed  PubMed Central  Google Scholar 

  105. Balibrea JM, Vilallonga R, Hidalgo M, Ciudin A, Gonzalez O, Caubet E, et al. Mid-term results and responsiveness predictors after two-step single-anastomosis duodeno-Ileal bypass with sleeve gastrectomy. Obes Surg. 2017;27(5):1302–8.

    Article  PubMed  Google Scholar 

  106. Greco F. Conversion of vertical sleeve gastrectomy to a functional single-anastomosis gastric bypass: technique and preliminary results using a non-adjustable ring instead of stapled division. Obes Surg. 2017;27(4):896–901.

    Article  PubMed  Google Scholar 

  107. Noun R, Slim R, Chakhtoura G, Gharios J, Chouillard E, Tohme-Noun C. Resectional one anastomosis gastric bypass/mini gastric bypass as a novel option for revision of restrictive procedures: preliminary results. J Obes. 2018;2018:4049136.

    Article  PubMed  PubMed Central  Google Scholar 

  108. Sharaiha RZ, Kedia P, Kumta N, Aronne LJ, Kahaleh M. Endoscopic sleeve plication for revision of sleeve gastrectomy. Gastrointest Endosc. 2015;81(4):1004.

    Article  PubMed  Google Scholar 

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Guerron, A.D., Sudan, R. (2020). Evaluation and Treatment of the Patient Who Is Regaining Weight. In: Patti, M., Di Corpo, M., Schlottmann, F. (eds) Foregut Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-27592-1_31

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